← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Helen Margellos-Anast, President of the Sinai Urban Health Institute at Sinai Chicago
00:20:21
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit BeckersHospelveue.com and click on the Events tab in the upper right.
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B
Welcome to the Becker's Healthcare Podcast. I'm Kelly Gooch, Senior Editor and Enterprise Lead at Beckers, and I'm pleased to welcome today Helen Margaus Annist, President of Sinai Urban Health Institute, part of Sinai Chicago, to the podcast today. Helen, thank you so much for joining us. I'm really looking forward to this conversation because your work stands at the nexus of community health health equity data driven strategy areas that of course are vi to improving outcomes and addressing disparities in urban healthcare settings today. So before we dive in, I'd love to start by having you introduce yourself and share a little bit about your background, your journey into public health leadership, and what really drew you to Sinai Urban Health Institute.
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A
Sure.
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C
Thank you. So yes, so as you said, I'm Helen Margallis Annist. I actually joined Sinai Urban Health Institute very close to its inception, so I have my Master's of Public Health in Epidemiology and I actually was looking for an opportunity after finishing my MPH to do so. All I knew is I wanted to do something really meaningful and I knew I wanted it to be in the United States. I wasn't really interested in international health, which is where a lot of people with those sorts of aspirations end up moving to. So I happened to come across it was divine providence. I happened to come across this posting for the newly formed signed Urban Health Institute in Chicago and as soon as I I started reading about the research that was going to be done around understanding health inequities at a hyperlocal level, working very closely with communities to understand what is driving those health inequities, and working towards innovative solutions. This is not necessarily how it's described at the time, but that was the gist of it. I knew I needed to be a part of this and thankfully I was able to join. I joined as a social epidemiologist and evaluator only a few months after Suhee was founded in 2000. I joined in 2001 and I have been blessed to have moved from that social Epidemiology role where I did a lot of research on understanding those health inequities. More into the innovation side and intervention side, I became very drawn to the action side of using data to get to the right actions and partnering with community to do that. I moved into a Director of Community Health Innovations role and then eventually senior research Director over all of Suki's offerings. And in May of 2020 into my current role as president, then I'm really committed also to leadership and understanding how we can collaborate towards addressing wicked public health and health issues. And so I completed my doctorate of Public Health in Public Health Leadership just last year in 2025. So that's a bit about my journey.
- [03:15]
B
Wow, what an amazing trajectory and journey that you've been on. And I wanted to ask maybe, of course, like you said with your most recent role, here's President, what was the most important initiative you led in the last year and what did you do and what were the results of that?
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C
Yeah, so before I do, let me just say a little bit about Sinai Chicago, because I think that's important and Suhee. So Sinai Chicago is the largest private safety net health system in Illinois. We serve over 100,000 patients and families that live on Chicago's west and southwest sides, areas of the city that have been disinvested for decades and that experience significant health inequities. So over 70% of our patients are insured by Medicaid or Medicare and actually the majority of those are Medicaid. We also have a large proportion that remain that are either uninsured or self pay and only 5% that are privately insured. That's really important to understand as the context from which Suhe, the part of Sinai that I lead does our work. We're really focused on that population of people who communities that have experienced tremendous challenges to optimal health and supporting those communities to meet their needs, their needs and to live their healthiest lives. The work that we do at Suhee is really focused in three buckets. The first is understanding health inequities at that hyperlocal level, starting with oftentimes quantitative data, existing data sources, surveys that we might do things of that nature to really dig into what we're seeing that might distinguish the communities that we are serving or working with, then really partnering with communities to bring additional insight into that. So qualitative data to expand on what we've seen with the numbers and to get the stories that drive those inequities. From there we move into more implementation and intervention work. So again Partnering meaningfully with communities and other partners that are going to support us in coming up with the right innovative solutions to those inequities. And then we want to make sure that we are measuring everything that we do. And that includes the outcomes of course, and the impact and, and then also the process so that we can scale what is successful. So that is where we're coming from. So when we think about the last year, I'm going to highlight a couple of initiatives. One in two of the buckets. So the first in the understand bucket, we in 2025 completed a study called Empower their Voice. And it was motivated by the fact that across the United States, girls mental health is known to be getting worse. I'm talking about adolescent girls. We know far less about what mental health and well being looks like for girls in Chicago and how it differs across neighborhoods and across racial and ethnic groups. So we were really interested in understanding that better. We didn't fully understand at that time what is shaping girls mental well being locally, particularly the role of community violence, social media and everyday responsibilities and what that might play. The empower your voice study was designed to fill that gap. It was a community engaged multi method study that partnered with more than 1,000 girls across Chicago to understand their mental well being and the conditions that influence that. We found for example, that rates of depression anxiety among Chicago girls were nearly twice the national average and that these challenges did not exist in isolation. We started to dig into some of the drivers of those and so as examples of that, 40% of girls reported contributing to family duties or household finances. Again, these are adolescent girls. 70% had witnessed or experienced community violence. These burdens were also found to not be evenly distributed with black and brown girls being disproportionately affected, carrying the greatest share of those stressors. Taken together, those findings made it clear that girls mental health in Chicago is shaped by structural conditions, not individual shortcomings. And that addressing mental well being requires investment in safer communities, supportive schools and systems that truly center girls voices and really gave us some data from which we are now launching more work in this space of supporting girls in their mental health well being. Another initiative I wanted to highlight is the continued integration of community health workers into Sinai Chicago. Sinai is focused on ensuring we're reaching all of our patients effectively and that we're addressing their specific health needs. One of the areas we focus a lot of our research on for over two decades is the community health worker model. And in fact, when I joined Sinai those 25 years ago now, it was Specifically as the evaluator of what is actually our first ever pediatric asthma intervention that utilized community health workers. So we've been doing this work for a lot of a long time. Community health workers, for anyone who may not be familiar, are frontline public health workers who are from the communities that they serve, so they don't have to have any specific education. Depending on the state they're in, they may need to have some specific training to be certified as CHWs to be reimbursable. But the main thing that we're looking for in a community health worker is that they're from the community, that they speak, quote, unquote, the language of the community, that they're culturally sensitive to the community, that they know the assets that are present in that community and that they can navigate people, connect with them in very trusting ways quickly, and then navigate them to the resources they need to have optimal health and well being. So, so we've been working on this since our inception. In 2000, we started more in chronic disease prevention and management research, having developed models in asthma, diabetes and breast cancer. We then have developed some models around screening for social health and connecting people to resources more broadly in complex care management and most recently in behavioral health. This integration into Sinai really started in 2019. We began thinking about how do we take the research we've done and integrate it more into our direct services. And while it has not been a smooth road, there've been bumps along that, learned a lot along the way and we've kept at it and we're now integrated into many areas of Sina Chicago and continue toward, are continuing to work towards integrating into even more. And there's been a lot of progress in that space this past year. So we have the base program. Here is the CHWs assisting patients program. And this program starts in the ED and on the inpatient side generally, and continues back to home. The role of the CHWs is to establish a relationship with the patient, screen them for their social needs and connect them actively to medical and social care as needed post discharge. They also continue to connect with patients for at least 30 days post discharge and longer if needed to ensure discharge instructions are clear, that appointments are made and kept, and that all barriers are addressed. We also receive referrals from other parts of the health system, other social workers, providers who may, if we don't connect directly with a patient while they are with us. And so we also will follow up with patients post discharge as needed. And some of the metrics, again, as I said, we started trying to do this work in 2019, it really launched in 2020. And the metrics I'm going to give you are through December of 2025. But it really accelerated in the past year. We really have added more community health workers and have gotten more integrated into our system. So over that period, we have screened over 18,000 people for social needs. The greatest needs have been around needing transitions to primary care, with about 20% of our patients needing that support. Food insecurity is another big one. About a quarter of our patients have food insecurity and need support in that space, transportation to get to appointments and to access what they need, about 20%. Then other prevalent needs have been utilities and housing. We find that our average patient has two needs that they need support with. And there's a wide range, but the average patient has two. And we have seen some impact in our 30 day readmission rates between those who are screened in other patients and those who participate in our program. The rest of the population, with readmission rates among screened patients being nearly 8% lower. So that's a program that we have basically integrated into every part of our system. On the inpatient side at this point, we have community health workers specifically focused on behavioral health, on supporting women through the maternal child health process, from prenatal through delivery and postpartum into supportive oncology into mammography. And we're working to integrate more into the outpatient setting. So we have this connection of care between those settings networked by our community health workers.
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B
Thank you so much, Helen. Just amazing work there. Sounds like from the girls mental health aspect, of course, community health workers, just all of those results. So, so wonderful to hear about and wanted to ask you as you continue this work and just looking ahead, any other just big priorities and headwinds you're really focused on for 2026?
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C
Yeah. So in terms of priorities, we will continue this work that I just described around integrating community health workers into Sinai. We also want to and have been supporting organizations beyond Sinai in doing the same. So that is going to remain a huge priority in 2026 and beyond. We have learned a lot about how to do this effectively over the time that we've been doing our work. And actually in 2017 we founded Crowd, which is our CHW center for research Outcomes and Workforce Development. And, and through that center, we already have worked with over 80 organizations and trained over 4,000 community health workers across the country. And what we want to do is we want to support organizations in bringing on community health workers and effectively integrating, sustaining them. So we're very focused on continuing to grow that work. Especially as in Illinois. We are right now in 2026, we should be seeing Medicaid reimbursement for CHWs beginning to be something that we can access. That is, that seems to still be on schedule to happen. And with that we want to make sure that all organizations that have CHWs have the means to access Medicaid reimbursement. It's going to be easier for healthcare systems, it's going to be harder for smaller CBOs, community based organizations. So that is a space where crowd will continue to do some work and we're really interested in continuing that work. Another area that Sinai is very focused on and that SUHEE is heavily supporting and leading is we are building out science capacity to engage as a clinical trials research site. As you probably know, clinical trials are the engine of medical progress. They often offer the best opportunities for people to get access to cutting edge, potentially life saving and definitely life improving treatments, especially for rare diseases or ones that we do not yet know how to treat well. Yet too often patients served by safety net providers, hospitals like Sinai, federally qualified health centers and community health centers are left out of that process because those organizations don't have the infrastructure to host clinical trials. We want to change that and we're doing that at Sinai by embarking on some partnerships and a journey to expand our ability to do so and to be parts of those trials. So we're very actively focused on getting that going in the next few months. We also though want to again support that happening more holistically across the system. And so by applying the lessons we've learned from decades of community driven work, SUHEE can support that. We know what we need to do to make trials also more accessible to people living in our communities. Because it's not only about the health systems and being able to offer them, it's also about people being able to access them. And something like taking half a day off work to go to a hospital to do what you need to do to participate in a trial is not a realistic reality for many people in our communities. We're also working towards figuring out ways to make them more accessible to our population through some innovative methods. In that same vein, we want to continue to test the application of new technologies towards reducing health inequities. That's another area that we're really picking up and doing more work in. And that has to date been more around testing the uptake and outcomes associated with tech, wearable devices and apps, things like that. Food access apps is One example and being on that end. But we also want to increasingly partner on the development side and supporting the development of these apps and these technologies so that they are more accessible to all the communities and populations that need them. And then finally, we will be continuing to focus on business development towards long term sustainability. That's probably more important now than ever because of some of the headwinds that we are experiencing. So a little bit about some of the most prevalent headwinds we're seeing and I'm anticipating in our specific area first is the shifting governmental priorities and policies with less resources being allocated towards the safety net. That is a challenge for us in terms of identifying funding through some of our traditional funding sources. And it's also a challenge for our communities as they lose access to some of the benefits that they have access to now. So we're very focused on addressing that headwind by supporting our communities and doing everything they need to to keep their benefits. So if they should be eligible to help them navigate the process, which is going to be how many people will likely fall off and then, you know, we'll be monitoring in terms of Sinai and the safety net in our own funding as well. What is coming, another headwind is really this lack of stability and a lot of uncertainty that makes it really difficult to plan and be strategic more than three months ahead. That's really been a challenge that I've been navigating that we will continue to navigate, keeping that long term vision while also realizing that the environment around us might be shifting regularly. Another headwind that we face, and this is not new, but it's something that we, as we at Suhee and at Sinai, try to continue to become more innovative and bring in more business opportunities, is that we don't have a lot of resources to invest beyond the day to day care of our patients. Suhee has been building some of that up through some of our innovation work and reinvestment. But that's a challenge because we don't have necessarily resources to invest in business planning and communication. And so we need to continue to figure out ways to do that in partnership.
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B
Absolutely. Lofty goals and big headwinds as well, all at the same time. And so anything else, Helen, that you would want to mention as far as maybe the hardest thing you'll have to do in the coming year and also just where you see the best opportunities for organizational growth as well?
- [17:23]
C
Sure. I think in terms of the hardest things, one is what I was speaking to a moment ago, which is making sure that we stay strategic and Keep our long term vision in mind while we're navigating some uncertainty in the coming months and potentially years. So that's something that I've been doing, I mean we've been doing for the past year and we need to continue to do so. Not losing sight of our vision but continuing to move forward. That is going to be challenging, but we need to keep doing it. The other for me in terms of hard things to do, again this is continuing from last year is managing the morale of my team. That's a big challenge in this current environment. So I run an applied public health research institute that is affiliated with Illinois's largest private safety net health system. And we know the work we do is critical, important and has changed so many lives. And that why is what motivates myself and the majority of my team to stay and do this work. We have a team that a lot of us have been with Suhee for a very long time. So there is this intrinsic motivation. We, we are the work we do. And yet that work from many places currently is being devalued. So we are right now disregarding science in some areas, devaluing the importance of evidence based practice, deprived, prioritizing and even villainizing public health. And that's challenging for my team. So I need to keep them and myself focused on not being so responsive to some of the things we experience externally and leaning even more into the partnerships that we have that give us strength. And together through multi sector partnerships, I think we're going to make a lot of headway. I know we're going to make a lot of headway. So that really in terms of opportunities for growth is where we're focused. More strategic partnership, bringing better visibility to Sinai Suhe and the communities we serve, Recognizing the problems we're dealing with and those that really hold health and equities in place are not simple ones. They're complex, they're working at problems and they're requiring multi sector partnership. We learned a lot on how to best partner with communities to develop trusting relationships, allow us to diagnose root causes and develop the right innovative solutions. We want to keep continuing and deepening our existing partnerships with academic institutions, governmental, public health, community based organizations and others, while also bringing in new partners from other sectors such as business and industry and tech companies. I think that in addition to giving us growth opportunities together, that is really how with our collective wisdom and with a collaborative learning culture, we can begin to make transformational change that will bring us to the place where all communities are thriving in health Absolutely.
- [20:04]
B
Well, thank you so much, Helen, for this wonderful and interesting conversation. Exciting to hear about what lies ahead. I really do appreciate your time and look forward to working with you again soon.
- [20:15]
C
Thank you. Thank you for having me.